Measles on Kauai
sets off a full alert

Although it is only 1 case,
the state Health Department
fears an outbreak

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By Helen Altonn
Star-Bulletin

One case of measles on Kauai has triggered a state Health Department measles alert and a free clinic for measles shots today.

Health officials fear more people may have contacted the disease from a 16-year-old boy, who has been hospitalized.

The teenager had not been vaccinated for measles, and, looking at where he lives, "we think there are a lot of unvaccinated children, teens and adults in this area," said Judy Strait-Jones, project coordinator with the Health Department's Hawaii Immunization program.

Free vaccinations will be given from 3 to 6 p.m. at the Kilauea Neighborhood Center.

The boy had been in class before he was diagnosed with measles, Strait-Jones said, "so that's a concern, obviously."

She said the Department of Health is worried about 1-year-olds who cannot be protected because they are too young for the vaccine, and about young people and adults who have only had one of two shots necessary for protection.

Two vaccines that protect against measles, mumps and rubella, known as MMR, are required for school, Strait-Jones pointed out.

However, exemptions from immunization may be allowed for medical or religious reasons, she said.

She said she had no information about why the 16-year-old was in school without the required vaccinations.

"If this child, 16, had been vaccinated, then it wouldn't have happened. We think he possibly got it overseas and brought it back."

She said the last measles outbreak in Hawaii was in 1994 on the Big Island.

Health Department records show 12 cases occurring from September to November 1994 on the Big Island.

The last epidemic on Kauai was from May to June of 1984, with 106 cases identified.

"What made us quite apprehensive (with the 16-year-old) is, in 1984 we had one case, and it ended up being an epidemic," said Dr. Lee Evslin, pediatrician at the Kauai Medical Clinic, Lihue.

Measles is uncommon these days, he said. "Many modern physicians have never seen a case of measles. You don't see them in residency anymore. They're virtually gone, fortunately."

When measles does occur, however, it is very contagious , if they are not vaccinated. It can be contracted just by being in the same room with an infected person, the health officials said.

Symptoms include high fever, runny nose, cough and rash. Middle ear infections, pneumonia and other serious complications can occur.

The disease is fatal for one-third of every 1,000 persons reported with measles in the United States.

Evslin said the 16-year-old "has measles for sure, and he is quite contagious" and may have been in contact with others who have not been immunized. There is a lot of concern in his community, the doctor said.

He said patients are contagious one to two days before the onset of the illness, which is a problem with many illnesses, including chicken pox.

"What happens with measles, they're sick first, in a more nonspecific way at first, then the rash comes out, and it becomes more and more obvious what it is, but it doesn't happen at first.

"So you have a person who is quite contagious before they have anything, then they just have a fever, and they aren't sure what's going on, and it can be spread easily."

Although it is considered a childhood illness, people of all ages who have not been vaccinated or have not had measles can develop them.

All children one year of age and older, and all adults born in the United States after 1956, should be vaccinated with two doses of vaccine, the Health Department said.

Anyone wanting to be vaccinated at the free clinic should take their vaccination record with them. If they do not know if they received a measles shot previously, they should check with their doctor before going to the clinic.

More information may be obtained by calling the Health Department at 1-800-933-4832.